1. Field of the Invention
The present invention relates to an apparatus or diagnosing inflammatory conditions in connection with periodontitle, and the invention also involves a process for such diagnosis.
2. Description of Related Art
The loosening of teeth (periodontitis) is a bacterially caused inflammation in the attachment apparatus of the tooth (periodontium) which, if left untreated results in decomposition of the bone around the tooth (resorption) and of the tooth loosening its anchorage, the anchorage being ultimately lost. Periodontitis shall primarily be prevented by good oral hygiene but may also, after being established, be treated. This treatment will mainly be directed to interrupt the progress of the disease.
Practically all adults are to a greater or lesser degree subjected to the disease, and approximately 10% of the population in the industrialized world develop severe periodontitis resulting in partial or total loss of the teeth.
Periodontitis is initially a disease which to the patient lacks symptoms. However, the dentist can see early signs of an incipient disease development. The gum around the teeth become red, swollen and bleed easily, i.e. show signs of an inflammation. Simultaneously the pocket between tooth and gum will be subject to increased depth. In this pocket additional bacteria will accumulate and proliferate (plaque). Gradually the bacteria will calcify and calculus will form on the teeth. Synchronously with the formation of plaque the inflamation spreads in the attachment apparatus of the tooth and the bone surrounding the root of the tooth starts to decompose.
The methods available to the dentist to diagnose periodontitis is measuring the depth of the periodontal pocket around the tooth and registering the tendency for bleeding connection herewith. However, this does not give a full measure of the degree of inflamation in the attachment apparatus of the tooth. Above all these measures give little guidance for judging how the disease will develop. They rather reflect what has already taken place.
One of the greatest problem in the treatment of periodontitis is to be able to predict around what teeth the periodontitis activity will increase. It has been found that the loss of supporting tissue around the teeth in periodontitis fluctuates, i.e. periods of low disease activity succeed periods of high activity. Early signs of this can be seen in the degree of inflammation in the environment of the teeth. An incipient increase of the degree of inflammation should be treated as soon as possible in order to save as much as possible of the anchorage of the tooth. The traditional methods (depth of periodontal pocket and bleeding tendency) in order to estimate this condition are not reliable. A deep periodontal pocket does not necessarily mean that the periodontal process is active. A healing process may have started in the same manner a shallow periodontal pocket may not mean that the periodontal disease is inactive. Also a deep pocket has once been shallow and it is very important to be able to predict which periodontal pockets are subject to deepening.
The cardinal symptoms of a topical inflammatory condition is calor (temperature increase), dolor (pain), rubor (redness) and tumor (swelling). Out of these the redness (bleeding in the periodontal pocket) and the swelling (in combination with decomposition of alveolar bone, i.e. measuring depth of periodontal pocket) have traditionally been used to diagnose periodontitis. However, these symptoms of periodontitis are not reliable measures for estimating the activity of the disease. Furthermore, it is not possible to estimate bleeding quantitatively. These traditional methods, measuring of pocket depth and bleeding tendency, to judge the activity of the periodontal process often give misleading results, particularly in an early stage of an active period. A deep periodontal pocket which is bleeding does not always mean that the process is active.
The use of temperature as a measurement for the activity of periodontitis is based on the fact that an inflammatory process in view of increased flow of blood results in an early temperature increase (before the depth of the periodontal pocket has increased). However, in the mouth the temperature varies between different areas. The gum is warmer the deeper in the oral cavity the measurement le made (32.degree. C. to 37.degree. C.). An absolute temperature scale to estimate the degree of inflammation is thus not possible to define. However, the surface temperature in the opening of the periodontal pocket is not affected by a possible inflammation at the bottom the periodontal pocket.